| NPI | 1023415924 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: TX DT86341) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: PA DN003760) |
| Enumeration Date | 2014-11-21 |
| Last Update Date | 2022-05-17 |